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[磨牙拔除后牙槽嵴保存的影像学评估:一项对照临床试验]

[Radiographic evaluation of ridge preservation after molar tooth extraction: a controlled clinical trial].

作者信息

Zhan Ya-lin, Hu Wen-jie, Zhen Min, Xu Tao, Lu Rui-fang

机构信息

Department of Periodontology, Peking University School and Hospital of Stomatology, Beijing 100081, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2015 Feb 18;47(1):19-26.

Abstract

OBJECTIVE

To compare the bone dimensional changes following tooth extraction alone with extraction plus ridge preservation (using deproteinized boving bone mineral Bio-Oss® and bioresorbable collagen mambrane Bio-Gide®) in periodontal compromised extraction sockets.

METHODS

Eighteen molars of sixteen subjects requiring tooth extraction because of periodontal destruction were enrolled in this study. The subjects were assigned to the control group (extraction alone, EXT) or to the test group (ridge-preservation procedure with Bio-Oss® and Bio-Gide, RP). Parallel periapical X-rays and cone-beam computed tomography (CBCT) scans were taken immediately after tooth extraction alone or plus ridge-preservation (baseline) and 6 months later. The changes of horizontal ridge width and vertical ridge height were assessed.

RESULTS

At the central buccal aspect, the ridge height increased 2.9 mm in RP group, and reduced 1.0 mm in EXT group. At the distal buccal aspect, the ridge height increased 1.45 mm in RP group, and reduced 1.45 mm in EXT group. The differences between the groups reached statistical significance (P<0.05). The mean ridge width increased at the 1 mm below the crest (the horizontal ridge width was measured with grafting material at three levels at 1 mm below the most coronal aspect of the crest,HW1), which amounted to 3.40 to 5.80 mm in RP group, and 1.45 to 2.90 mm in EXT group. The mean ridge increased at the 4 mm below the crest (the horizontal ridge width was measured with grafting material at three levels at 4 mm below the most coronal aspect of the crest,HW4), which amounted to 0.40 to 3.50 mm in RP group, and reduced 0.10 to increased 0.15 mm in EXT group. The test group and the control group were not significantly different (P>0.05).

CONCLUSION

The ridge-preservation approach using Bio-Oss® in combination with Bio-Gide® can significantly increase vertical ridge height and horizontal ridge width after tooth extraction compared with extraction alone in periodontal compromised molars.

摘要

目的

比较在牙周受损拔牙窝中,单纯拔牙与拔牙加牙槽嵴保存(使用脱蛋白牛骨矿物质Bio-Oss®和可吸收胶原膜Bio-Gide®)后的骨尺寸变化。

方法

本研究纳入了16名因牙周破坏而需要拔牙的受试者的18颗磨牙。受试者被分为对照组(单纯拔牙,EXT)或试验组(使用Bio-Oss®和Bio-Gide进行牙槽嵴保存操作,RP)。在单纯拔牙或拔牙加牙槽嵴保存后(基线)以及6个月后立即拍摄平行根尖X线片和锥形束计算机断层扫描(CBCT)。评估水平牙槽嵴宽度和垂直牙槽嵴高度的变化。

结果

在颊侧中央,RP组牙槽嵴高度增加2.9mm,EXT组降低1.0mm。在颊侧远中,RP组牙槽嵴高度增加1.45mm,EXT组降低1.45mm。两组间差异有统计学意义(P<0.05)。在牙槽嵴顶下方1mm处(在牙槽嵴最冠方以下1mm处的三个水平用移植材料测量水平牙槽嵴宽度,HW1)平均牙槽嵴宽度增加,RP组为3.40至5.80mm,EXT组为1.45至2.90mm。在牙槽嵴顶下方4mm处(在牙槽嵴最冠方以下4mm处的三个水平用移植材料测量水平牙槽嵴宽度,HW4)平均牙槽嵴增加,RP组为0.40至3.50mm,EXT组降低0.10至增加0.15mm。试验组和对照组差异无统计学意义(P>0.05)。

结论

与牙周受损磨牙单纯拔牙相比,使用Bio-Oss®联合Bio-Gide®的牙槽嵴保存方法可在拔牙后显著增加垂直牙槽嵴高度和水平牙槽嵴宽度。

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